Improved Cancer Screening: Life Skills Training in S Texas Hispanic Communities

改进癌症筛查：德克萨斯州南部西班牙裔社区的生活技能培训

• 批准号: 7429093
• 负责人: THELMA C HURD
• 金额: $ 21.72万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-04 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7429093
• 关键词: Acculturation; Address; Affect; Attitude; Behavior; Behavior Therapy; Belief; Body of uterus; Breast; Breast Cancer Detection; Cancer Control; Cancer Intervention; Cardiovascular Diseases; Caucasians; Caucasoid Race; Cervical; Cervical Cancer Education; Colorectal; Colorectal Cancer; Communities; Community Health; Community Surveys; Complement; Consumption; Country; County; Diabetes Mellitus; Diagnosis; Diagnostic Neoplasm Staging; Disease; Early Diagnosis; Early treatment; Education; Educational Curriculum; Educational Materials; English Language; Enrollment; Face; Family; Female; Focus Groups; Goals; Health; Health Resources; Health Services Accessibility; Health behavior; Health behavior change; Health education; Healthcare; Healthcare Systems; Hispanics; Hour; Husband; Incidence; Intervention; Interview; Knowledge; Lead; Life; Linguistics; Link; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Medical; Mexican; Mexico; Modification; Morbidity - disease rate; Numbers; Obesity; Outcome; Outcome Measure; Pilot Projects; Population; Prevention; Prevention education; Preventive Health Services; Prostate; Public Health; Randomized; Rate; Relative (related person); Reporting; Research; Rural; Screening for cancer; Screening procedure; Social support; Socioeconomic Factors; South Texas; Staging; System; Testing; Texas; Training; Treatment Cost; Ursidae Family; Woman; Women' s Role; base; cancer diagnosis; experience; family structure; health care service utilization; improved; malignant breast neoplasm; men; mortality; novel; programs; skills training

DESCRIPTION (provided by applicant): Mexican women with breast or cervical cancer in South Texas are diagnosed at later stages. The higher mortality rates are due in large part to low screening rates. Tailored, culturally relevant cancer interventions that change health behaviors are urgently needed. This project's long term objective is to decrease late stage diagnosis of breast and cervical cancer among Hispanic women in South Texas and the Texas border region. The central hypothesis is that culturally relevant community based breast and cervical cancer intervention, education and screening programs combined with life skills training will synergistically increase breast and cervical cancer knowledge and improve screening rates. Aim 1 will survey community attitudes toward female-centered, faith based cancer initiatives targeting Mexican men and women living in four South Texas communities. Aim 2 will pilot a South Texas Hispanic version of Esperanza y Vida, a novel, culturally tailored, community based breast and cervical cancer education program in diverse South Texas Hispanic communities. Aim 3 will evaluate the effect of life skills training on health behaviors among Mexicans who have completed a breast and cervical cancer education program. This project will be conducted in four distinct, underserved Mexican populations (2 rural, 2 urban) in Webb, Hidalgo and Nueces Counties. Focus groups and key informant interviews will be conducted to assess breast and cervical cancer knowledge, attitudes, beliefs and practices among Hispanic women and men in each community. A novel, community based breast and cervical cancer education and screening program (Esperanza y Vida) has been modified to meet the needs of South Texas Hispanic women and men. This study will randomize 240 women and 100 of their husbands to 1 of 4 study groups: Group 1 will attend a 2 hour Esperanza y Vida program, Group 2 will attend the 2 hour program Esperanza y Vida program followed by expanded Esperanza y Vida education program (12 sessions that cover each topic presented in the initial program), Group 3 will attend the 2 hour Esperanza y Vida program followed by life skills training (10 sessions), and Group 4 will attend the 2 hour Esperanza y Vida program followed by the expanded Esperanza y Vida education program and life skills training. Screening practices, barriers and breast and cervical cancer knowledge will be assessed at the end of the initial 2 hour program. Breast and cervical cancer knowledge will be assessed following each intervention in study groups 2-4. The primary outcomes measured are a) change in breast and cervical cancer knowledge and b) the number of completed screening exams. Parametric and non-parametric statistical analyses will be used to compare screening practices, barriers, breast and cervical cancer knowledge and number of completed screening exams between groups. PUBLIC HEALTH RELEVANCE: Effective cancer control and prevention public health strategies are needed in Texas where health resources are increasingly limited in the face of rapidly expanding population needs. Forty} 60% of breast and cervical cancers are diagnosed at advanced stages when treatment costs are high. The current health care system can not bear this burden. Education, screening and prevention combined with changes in health behaviors will result in a greater proportion of early stage cancer at diagnosis which in turn will lead to lower health resource consumption and most importantly, a healthier population. This project represents the start of a 10-year plan to increase cancer preventive health services utilization and modify health behaviors among Mexican men and women living in South Texas and the US-Mexico border region. The overarching goal is to decrease breast and cervical cancer incidence and mortality. Durable community partnerships have been developed that will enable a multi-tiered, community based approach to cancer control and prevention that respects and complements Hispanic sub-populations' culture.

描述（由申请人提供）：在德克萨斯州南部患有乳腺癌或宫颈癌的墨西哥妇女在后期被诊断出来。死亡率较高在很大程度上是由于筛查率低。迫切需要量身定制的、与文化相关的癌症干预措施来改变健康行为。该项目的长期目标是减少德克萨斯州南部和德克萨斯州边境地区西班牙裔妇女中乳腺癌和宫颈癌的晚期诊断。核心假设是，与文化相关的基于社区的乳腺癌和宫颈癌干预、教育和筛查方案与生活技能培训相结合，将协同增加乳腺癌和宫颈癌知识，提高筛查率。目标1将调查社区对以女性为中心、以信仰为基础的癌症倡议的态度，这些倡议针对居住在德克萨斯州南部四个社区的墨西哥男性和女性。目标2将试点南德克萨斯州西班牙裔版本的埃斯佩兰扎和维达，一个新颖的，文化上定制的，以社区为基础的乳腺癌和宫颈癌教育计划在不同的南德克萨斯州西班牙裔社区。目标3将评估生活技能培训对完成乳腺癌和宫颈癌教育计划的墨西哥人健康行为的影响。该项目将在韦布、伊达尔戈和努埃西斯州四个不同的、得不到充分服务的墨西哥人口（2个农村人口，2个城市人口）中开展。将进行焦点小组和主要知情人访谈，以评估每个社区西班牙裔妇女和男子对乳腺癌和宫颈癌的知识、态度、信仰和做法。一个新的，以社区为基础的乳腺癌和宫颈癌教育和筛查计划（埃斯佩兰扎和维达）已经修改，以满足南得克萨斯州西班牙裔妇女和男子的需要。这项研究将240名妇女和100名丈夫随机分为4个研究组：第1组将参加2小时的Esperanza y维达计划，第2组将参加2小时的Esperanza y维达计划，然后是扩展的Esperanza y维达教育计划（12节课，涵盖初始课程中的每个主题），第3组将参加2小时的Esperanza y维达课程，然后进行生活技能培训（10节课），第4组将参加2小时的Esperanza y维达计划，然后是扩展的Esperanza y维达教育计划和生活技能培训。筛查实践，障碍和乳腺癌和宫颈癌知识将在最初的2小时计划结束时进行评估。在研究组2-4的每次干预后，将评估乳腺癌和宫颈癌知识。测量的主要结果是a）乳腺癌和宫颈癌知识的变化和B）完成筛查检查的数量。将使用参数和非参数统计分析来比较组间的筛查实践、障碍、乳腺癌和宫颈癌知识以及完成的筛查检查数量。公共卫生相关性：有效的癌症控制和预防公共卫生战略需要在得克萨斯州的卫生资源越来越有限，面对迅速扩大的人口需求。40%的乳腺癌和宫颈癌是在治疗费用高昂的晚期被诊断出来的。目前的医疗保健系统无法承担这一负担。教育、筛查和预防结合健康行为的改变将导致诊断时早期癌症的比例更高，这反过来将导致更低的卫生资源消耗，最重要的是，人口更健康。该项目代表了一项10年计划的开始，该计划旨在提高癌症预防保健服务的利用率，并改变生活在德克萨斯州南部和美墨边境地区的墨西哥男女的健康行为。总体目标是降低乳腺癌和宫颈癌的发病率和死亡率。持久的社区伙伴关系已经建立，这将使一个多层次的，以社区为基础的方法来控制和预防癌症，尊重和补充西班牙裔亚人口的文化。